31
Bethesda, Maryland | September 19-21, 2013
T34
Identification as Overweight by Medical Professionals: Relation to
Eating Disorder Risk
Andrea E. Kass
1
,
Annie Z. Wang
2
,
Rachel P. Kolko
1
,
Jodi C. Holland
2
,
Mickey Trockel
3
,
C. Barr Taylor
3
,
Denise E. Wilfley
1, 2
1
Washington University in St. Louis, St. Louis, MO, USA,
2
Washington
University School of Medicine, St. Louis, MO, USA,
3
Stanford University
School of Medicine, Stanford, CA, USA
The American Academy of Pediatrics recommends routine screening for
pediatric overweight and obesity, yet provider adherence to guidelines
is poor. One barrier is concern that discussing weight with young adults
will increase risk for eating disorders (EDs). Clarification of the impact of
screening for overweight on ED risk is needed. 548 college-age women
were classified as at-risk or with a clinical ED, were objectively measured
for height/weight, and completed questionnaires to assess disordered
eating attitudes, behaviors, and relevant history, including the question,
“
Has a doctor, nurse, or other medical professional ever told you that
you were overweight?” 146 (26.6%) women reported being previously
identified as overweight. A significant association was found between being
screened as overweight and ED risk/symptom status (ps<0.01). However,
the association was nonsignificant after including current body mass index
(
BMI) as a covariate (ps>0.05). Adjusting for BMI, those screened as
overweight had higher weight/shape concerns (β=6.2; p=0.005), but no
difference in likelihood of engaging in ED behaviors (i.e., dietary restraint,
binge eating, purging behaviors, excessive exercise; ps>0.05) compared to
those not identified. Appropriate provider discussions to address overweight
status, offer healthy weight loss strategies, and encourage positive body
esteem might help to decrease ED risk. Given the cross-sectional study
design, longitudinal research is needed.
T35
Examining the Moderating Properties of Distress Tolerance and
Negative Urgency on the Link Between Binge Eating and Negative
Affect
Nichole R. Kelly, Elizabeth W. Cotter, Suzanne E. Mazzeo
Virginia Commonwealth University, Richmond, VA, USA
Purpose.
Theoretical models for binge eating point to negative affect
as a common precipitating factor. Yet, negative affect alone does not
fully explain binge eating. The current study examined whether distress
tolerance and negative urgency moderate the link between negative affect
and binge eating frequency.
Methods.
Adult women (
N
=493) completed
surveys assessing depression, global eating disorder symptomatology,
distress tolerance, behavioral impulsivity, and binge eating. Height and
weight were measured by research staff.
Results.
After controlling for body
mass index, race/ethnicity, and other domains of behavioral impulsivity,
negative urgency and distress tolerance independently moderated the
link between global eating disorder symptomatology and binge eating
frequency; they did not jointly moderate this association. Neither negative
urgency nor distress tolerance moderated the link between depression and
binge eating.
Conclusions.
Results support the role of difficulties tolerating
and responding adaptively to distress in increasing binge eating behavior.
The contribution of these difficulties may differ based on the negative
affective symptoms they interact with, supporting the potential for various
pathways leading to and maintaining binge eating behavior. Longitudinal
research is needed to clarify these potential pathways. Data from this
study may contribute to a transdiagnostic conceptualization of pathological
impulsive behavior, including binge eating.
T36
The Relationship of Binge Eating Disorder Features to Distress and
Impairment Outcomes
Kelly M. Klein, K. Jean Forney, Pamela K. Keel
Department of Psychology, Florida State University, Tallahassee, FL, USA
Introduction:
Binge Eating Disorder (BED) has been proposed for
inclusion in the DSM-5, using criteria originally included for research
purposes in the DSM-IV. However, most prior studies utilized DSM-
IV criteria without evaluating how well this definition (in particular the
associated features of binge episodes) relate to distress about binge eating
and general functioning. As such, specific diagnostic criteria received
relatively little vetting.
Methods:
Secondary analyses were performed on
data collected from SCID-1 interviews, using proposed DSM-IV criteria
for BED and Global Assessment of Function (GAF) scores. Participants
(
N=125; 90% women) were included if marked distress regarding binge
eating was assessed.
Results:
Individuals who endorsed distress about
binge eating had worse GAF scores and were more likely to endorse each
of the five BED associated features. In a multivariate model, however,
eating much more rapidly than normal was the only significant and
unique predictor of GAF scores.
Conclusions:
Among the associated
features of binge eating in BED, eating much more rapidly than normal is
a specific predictor of functioning and may provide sufficient information
regarding dysregulation of eating in BED. Future research should examine
associations of this and other associated features with clinical course and
outcome.
T37
Lexithymia in Anorexia Nervosa - Fact Or Fiction?
Bryan Lask
1
,
Shipra Berg
2
,
David Wood
3
1
Univ of London, London, United Kingdom,
2
Gt Ormond St Hospital,
London, United Kingdom,
3
Ellern Mede Centre for Eating Disorders,
London, United Kingdom
Purpose of study:
Alexithymia is often described as a component of
anorexia nervosa (AN). Recent studies have cast doubt on the extent to
which this is the case. This study investigates i) to what extent adolescents
with AN also have alexithymia ii) if so, whether this is fixed or changes
over time iii) the impact of controlling for depression.
Methods
:
Admission
and discharge scores on the TAS-20 were analysed for 42 females
with AN aged 12-18 on an adolescent eating disorder unit. Depression
was assessed using the BDI or CDI at both time points.
Results
:
Both
the TAS and depression scores, raised at admission, had dropped at
discharge.
Conclusions
:
There are a number of possible explanations for
these findings: i) the focus on emotional regulation during the admission
alleviated both depression and alexithymia ii) the reduction in alexithymia
causes depression to lift or vice-versa iii) the TAS simply measures
depression iv) the TAS is a marker of starvation and/or psychological
distress. The distinction between these options is important and worthy of
future research. It would be interesting to compare these data with TAS
and depression scores from a centre that does not focus on emotional
regulation.
T38
Self- and Parental Reports of Executive Functioning in a Sample of
Young Females with Anorexia Nervosa Before and After Cognitive
Remediation Therapy
Camilla Lindvall Dahlgren
1
,
Bryan Lask
1,2,3
,
Nils-Inge Landrø
4
,
Øyvind Rø
1
1
Oslo University Hospital, Oslo, Norway,
2
Great Ormond Street Hospital,
London, United Kingdom,
3
Care UK, London, United Kingdom,
4
University
of Oslo, Oslo, Norway
Introduction.
Cognitive remediation therapy (CRT) aims to increase
awareness of, challenge and change inefficient cognitive patterns through
a combination of practice and meta-cognitive techniques. The intervention
has only recently been developed for adolescents with anorexia nervosa,
and has yet to be formally evaluated.This study reports an evaluation of
CRT for this patient group using the self-report (SR) and parent form of
the Behavior Rating Inventory of Executive Functioning.
Methods.
20
female in- and outpatients (age 13-18) in treatment for AN participated in
8-12
individually delivered CRT sessions. As part of the baseline and post
intervention assessment, patients were asked to complete the BRIEF-
SR. An equivalent form of the questionnaire was also administered to the
patients’ parent(s).
Results.
We observed a significant increase in weight
after the intervention was completed. Also, preliminary analyses yielded
significant improvements in the subscale “shift” for the patients. Parental
reports demonstrated significant changes in the subscales “inhibit”, “shift”,
“
emotional control” and “working memory”.
Conclusions.
Results indicate
that parent’s perceive their children’s levels of executive functioning
significantly different post CRT, and that patients and parents differ
significantly on scores representing changes in behavior regulation.
T39
Are Food Restriction and Pressure-To-Eat Parenting Practices
Associated with Adolescent Disordered Eating Behaviors?
Katie A Loth
1
,
Rich MacLehose
1
,
Jayne Fulkerson
2
,
Scott Crow
3
,
Dianne
Neumark-Sztainer
1
1
University of Minnesota, School of Public Health, Minneapolis, MN, USA,
2
University of Minnesota, School of Nursing, Minneapolis, MN, USA,
3
University of Minnesota, School of Medicine, Minneapolis, MN, USA
Introduction
:
The aim of this study was to examine associations between
parental pressure-to-eat and food restriction and adolescent disordered
eating behaviors, within a large population-based sample of parent-
adolescent pairs.
Methods
:
Adolescents (N=2231) and their parents
(
N=3431) participated in two coordinated studies designed to examine
factors associated with weight status and weight-related behaviors in
adolescents. Adolescents completed surveys at school; up to two parents
per adolescent completed questionnaires via mail or phone.
Results
:
Findings indicate that adolescent boys exposed to higher levels of
pressure-to-eat or food restriction were significantly more likely to report
engaging in disordered eating behaviors compared to boys exposed to
lower levels of pressure-to-eat or food restriction. For example, for every
one unit increase in food restriction reported by mothers, boys were
1.16
and 2.07 times more likely to report engaging in unhealthy (p=0.01)
and extreme weight control behaviors (p=0.01) respectively. For girls,
the majority of findings were not significant in the examination of the
association between food-related parenting practices and disordered
eating behaviors.
Conclusions
:
Findings provide preliminary evidence
of a link between parental use of food restriction and pressure-to-eat and
endorsement of disordered eating behaviors in adolescent boys. Public
health and clinical implications of research findings will be discussed.
POSTER SESSION 1 ABSTRACTS
